Exercise and Rehab
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Sun, 07/05/2009 - 17:23
Ambiguous doctors and PTs - okay it's a rant
This is something that I've encountered quite a bit and it really hacks me off.
It seems like none of the physicians nor the PTs will actually provide definititve statements about back pain treatment and I really wonder why. I am not being hyperbolic here, I can't seem to pin down anyone when it comes to back pain or rehabilitation.
Me: "So, should I ice or heat the muscles?"
PT: "Well some do better with heat, others by icing."
Yeah, thanks for the clarification.
Me: "So how many Ibuprofins can I take?"
Doctor: "Well that depends on body weight, but 2400 mg a day should be okay - just don't do it for months."
Me: "But I've been hurting for 10 weeks now."
Doc: "Oh, well you should be fine anyway."
Hmm, any other conflicting information you'd like to offer?
From my PT "We can't advise on drugs."
"Any? Not even aspirin?"
"Nope, talk to your physician about that."
"Okay, thanks for nothing."
"Do these stretches and strenghtening exercises daily."
"Well, what about when they're sore?"
"In that situation don't do the stretches or exercises."
So basically I can't do the exercises until I stop hurting, at which point I don't need to do the exercises.
I try not to be argumentative or a jerk - but conflicting or confusing statements by physicians make problems like this worse. PT's that refuse to make definitive statements on ANYTHING are useless. If a PT can't tell me to either ice or heat my injured muscles then I question their abilities. Am I the only one who sees this? I go to a cardiologist for my high blood pressure - he can tell me 6 ways to heaven on what to do or not to do on blood pressure control. But I can't find a doctor or PT who can give me solid advice on how to repair injured back muscles. All I get is this ambiguous "work the core muscles" mantra.
And yet none of the exercises I've been given do that - they all work my lats, glutes, rhomboids, and hamstrings.
_____________
Ruptured Psoas, ruptured Quadrus Lumborum, sprained sacro-illiac joint, torn inner oblique (from the rehab, not the injury), slight bulge in L4-L5 disc.
Up until a week ago - totally pain free and back to a healthy workout and lifestyle. Now I'm back to square one.
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All I can say is... oh, ya, been there/done that.
To me, talking to my surgeon and my PM feels like I'm trying to pull teeth. My son tells me I am too agreeable, and that most of the time, I can put on a happy face even when I'm miserable, which makes my complaints seem contrary to the way I act. But, when I finally DO ask questions, I get the runaround, or I'm asked right back "what do YOU want to do?"
What's even more frustrating is when you know you won't be able to contact your doctor again for a while, and no matter how hard you try you either CAN'T get a straight answer, or you forget to ask a question... 
You know what I think would be great? A full course taught by health care professionals on how to talk to your doctor. I sometimes think that there is a "magic question" for each thing we want to address, and without the proper wording, we're out of luck.
~kat (my posts are from my own experiences only, I'm NOT a Doctor!)
(user error?)
"Whyme" previously known (or unknown) as "Jusserfinn"
Where did my sig go?
For some history, I guess just click on my name
YES! About ten years ago I injured my shoulder and my doc sent me to PT at the university of Michigan health centers and the treatment I received was outstanding!! I had the same person on EVERY visit and she actually remembered me from one visit to the next. She would give me straight answers to my questions and there was a doctor right there that would spend a couple of minutes with me every couple of weeks and actually examined my shoulder! After six weeks I was as good as new! Shortly after that I was in a car accident and my neck hurt so bad I thought I was going to die!! My useless doctor refused to do any x-ray or MRI he said "if your neck was broken you wouldn't be walking". I never said it was broken! Just that it was the worst pain I had ever felt! After several visits he still wouldn't give in on any testing so I asked him to refer me to PT. I went to the same place, but had a different person. Same excellent treatment! After a few months the pain level was almost nonexistent so I stopped going. Now ten years later i live in a small town in northern Michigan and I am seeing a pain doc for major issues with my lower back and I mention the neck issues to her and that the pain has been increasing and that I am suffering from horrible debilitating headaches so she immediately orders an MRI. They determine there is a large herniation at C5-C6 and major arthritis.I don't want to see the surgeon at this time so I ask her about PT. What a joke!! They have 3 therapists and 2 "office people" you never see the same person each time and sometimes you end up seeing all 3 in one visit!! At one visit one of the office people "took care of me" by having me ride the exercise bike for a half hour then lay on a heating pad for the rest of the time!! I once asked one of the therapists the ice/heat question and she told me to only use ice on an old injury! The next time I had a different therapist who freaked out and said NEVER use ice on an old injury! Well gee thanks for clearing that up!! Then there's the third therapist who won't commit to ice or heat but will explain in great detail how to make tiramisu!! Not kidding!!!
Anyway, thanks for a great topic! It really does help to share our stories with each other! And if we don't laugh at the stupidity it will just bring us down even more.
42 year old mom to Justin-21, Nick-19, Jessica-18 and
Grace-2!!
Click on my name to see medical history if you want to see info on Previous surgery, treatments, MRIs, etc.
8/13/09 First Surgery of 09: Lumbar Laminectomy, Forimanotomy, Fusion (no Optimesh). Woke up from surgery with no movement and very little feeling in legs - only front of thigh). Pain became worse over first few days and MRI revealed very large hematoma.
8/18/09 Second Surgery of 09 (hopefully last surgery ever!):
This surgery was neccessary to remove hematoma. While doc was in there he went much more invasive in clean up (attemting to restore legs) and put in Titanium Rods, the big screws (can't remember what they're called), and I think he mentioned a plate (will ask at check up). Woke up to the worst pain I have ever felt in my life! More pain than I EVER imagined possible!! No improvement to legs. A few days later, bladder and bowel problems began.
9/17/09 Update: I came home on August 28th by ambulance, insurance co refused rehab and doc felt I was not strong enough to make 4 hour trip by car. Truthfully, I wasn't medically ready to be home, but I sure was happy to be there and back home with my baby!! My right leg is about 80%, left is about 20% on a good day. The feeling that is coming back in left leg is mostly along the Sciatic Path and it hurts like hell!! I sure hope that goes away!! Still have catheter and a bladder infection to go with it. Came home with Pic Line so I could continue to receive Vanco twice a day. I became allergic to it and was deathly ill!! It felt like I was being poisoned!! For two days I could not eat and slept almost constantly!! I refused any more of that stuff on the 14th and I am slowly feeling human again. Hopefully in a day or two I'll be able to really get into the PT and maybe start getting around more. As it is right now if I really push myself I can make it about 40 feet with the walker and left leg in brace. Only to collapse on the bed in exhaustion and then sleep for about 4 hours!! This is definitely not me!!
Meds: Oxycontin 40mg (x2), Percocet 5/325 (x4 as needed), Soma 350mg (3-4 as needed), Synthroid 100mcg (x1), Cymbalta (for nerve pain) 60mg (x1).
Meds before Surgery: Hydrocone 10/325 (x8!), Zanaflex 4mg (x2). Ironically, one of the reasons I agreed to surgery was that I didn't want to be on Narcotics forever (and oxy ever! but it's now the only thing that works!) Let's see how that works out for me! lol!